FROM OUT OF THE BLUE

I got an email from a former colleague, a physician trained in geriactics who once practiced in the office next door to mine. We were good friends, and I often went to his office for a few minutes each day in order to pet his Portuguese Water Dogs, which he often brought to work. It was a good way to relax. If he sent me a patient, I would talk to him person to person about what I found. But this was a quarter century ago.

He is older than I and retired, not long after I went into administration, and took up farming in another state, where he was successful. We were part of his Christmas card list and heard each year about the family and the dogs. He had several health issues, but he was tough and got through each one.

About a decade ago, although I can’t be sure these days, because the years go by so fast, his Christmas cards developed a significant religious tone and he mentioned his involvement with several well known evangelists. I just wished him well, although the change didn’t resonate with me.

Then, about five years ago, not at Christmas, he sent out a e-mail to his address book complaining about the New World Order, how the UN would be stationing troops here, guns would be confiscated, and we would lose our freedoms. I don’t know much about this stuff, but to be honest, I thought it might be better than the Project for the New American Century, which did exist and was behind the Iraq and Afghanistan wars. I wondered if my friend, or really ex-friend now, might be becoming demented. That’s tough to diagnose, so I said nothing and heard nothing more. I now wish most people well, even my so-called detractors, so long as they don’t interfere with my attempts to quietly lead my life. I must be mellowing.

Today, out of the blue, after at least a 3 year hiatus, I heard from him.

He isn’t demented, which was the good news. The first “How are you?” was, unfortunately, followed by a video clip of Hillary Clinton’s supposed Parkinsonian symptoms that he wanted me to view, along with several other attachments, all on YouTube.

I’ve heard these allegations before. I didn’t notice anything obvious about her at the Convention, but I didn’t look carefully. Bill looked like he lost a lot of weight, maybe too much. I do know Mr. Trump is 70 and has been overweight for years. That is a significant concern to me. My board certification is from the American Board of Psychiatry and Neurology, so I can say with some confidence Mr. Trump meets the criteria for narcissistic personality disorder, and the press has often given him a free pass on that and virtually everything he has said, the free advertising likely to elect him president, in what is becoming the highest stakes reality TV ever, given the country’s infatuation with media celebrities. Ms. Clinton has been a public servant for 35 years, long enough to make mistakes, long before the millenials, who are “cool to her,” were born. Trump’s failed business ventures, failure to release his tax returns, his boorishness, racism, xenophobia, bullying, and litigation don’t appear to bother much of the electorate, including his ridiculing those with disabilities (a reporter), injuries (Harry Reid), nervousness (the woman in Flint), or his suggesting violence (that the Secret Service not guard Ms. Clinton).

I do not like it when my detractors want me to read a series of articles or look at videos with the idea that I must be changed to their way of thinking, because for years, I read their articles, the ad hominem attacks, the statistics that were clearly in error, the bias, the grammatical mistakes, the inflammatory language, and I was not convinced.

I will not reply. Silence is best. He will not know whether I received it or what I think. I will not look at the video. I have no way of knowing how it was edited, whether the purported “freezing” is like “Hitler’s jig” when France fell. I have no way of knowing if her silent speech was in a focus group and dubbed in to another speech. And if I say she doesn’t have clinical Parkinson’s, a view which her facial expression on a post today would support, somebody will come back and say I haven’t practiced in years, which is true. Anything short of agreeing with him will likely lead to an argument I want no part of.

I’ve seen thousands with Parkinson’s, was involved in a clinical trial of bromocriptine; many patients functioned well mentally and physically. One can outwork me at Rowe Sanctuary in Nebraska every spring and at age 70 taught me the definition of an acre (it’s 10 chains squared, and a chain is 22 yards.)

Bet Mr. Trump doesn’t know that. Mr. Cruz said we had billions and billions and billions of acres owned by the federal government. The country outside of Alaska has 1.9 billion acres total, and non-public land in Texas alone has about 161 million of it. A great majority of the land east of the Mississippi is not public. Candidates for public office ought to be required to say what a billion or a trillion is operationally, before they can run for office. I bet many wouldn’t be able.

As for presidents with disabilities, FDR ran the country for 12 years, during the Depression and WWII, in a wheelchair. John Kennedy had Addison’s Disease. Johnson had severe enough heart disease to require a defibrillator nearby. Carter almost collapsed on a run in Catoctin. Ford tripped coming down Air Force One and became the butt of many jokes. Reagan was shot and had Alzheimer’s for a significant part of his last term. The first Bush vomited on the Japanese prime minister and fainted at a state function. His son was an alcoholic.

The sudden claim of Parkinson’s for Hillary Clinton is odd, since the supposed symptoms quoted are usually seen late, and she has been in the public eye for years.

I was disappointed, but not surprised, when after a venous thrombosis in her skull four years ago gave her diplopia (double vision), it was treated by the Congressional Republicans as a minor headache, a skimpy excuse keeping her from testifying before Congress on one of their many Benghazi investigations. She is subject to a double standard. When Ms. Clinton had a rather common illness—I’ve had pneumonia and hallucinated, but I returned to practice medicine three days later—it was blown out of proportion. When it comes to Parkinson’s, I’m sure there are some neurologists who without an exam, but with bias, repetition, and intimidation, will claim that she does. And so what? Parkinson’s has treatments. Narcissism?

Both presidential candidates are at an age where bad things happen to people. I am at that age, too. Being old means that the vice presidential choice matters. One thing scares me more than Mr. Trump, and that is having him incapacitated. Trump at least isn’t a social conservative. Governor Pence would send us back to the 19th century in our treatment of women.

I don’t need “re-education.” I can teach math, statistics, neuroanatomy, guide people on hikes, show them the night sky, and teach them what happened when the most civilized society in the world became fascist.